87156A - Atlantic Telephone Membership Corp

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CAMA ❑DREDGE & FILL Na 87156 fl B C D
PrevENERAL PERMIT DateprspouspDate previous permh Issued❑Modification ❑Complete Reissue El Partial Reissue
As authorized by the SState
;;off' North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
ISA NCAC ��L-Sp.CC)
---- u Rules attached. k] General Permit Rules available at the folbwNg Zink: yyWw.deo.r&.ggv(CJJ'1Anrlos
Applicant Name�\C.. _-Te(,-6yioAe 11,4%'i1 Wcc.-r+r.., 1,... J)A
rover rs ,.. ��it Vt"i o��/+ r�.�s Project Location iG WQh
city 5'►Ktlloii�e State _._hCzIP 28-IJ't street Addn:.ss1State Roadaot#(s) OFF L I
Phone#(9ts?)
Email Kitts_,,, ®C2.`-dk.S_G. Subdivision
City
ABectod L!C ❑EW ®PTA F]Es ®PTS Adj. Wtr. Body 1.i,>C. �_ yPUja_Q (Eiinwunk)
AEC(s)- jJOEA ❑IMA nUW LJSPIMA E]PWS Closest Ma). Wtr. Body--_Fr?{�l\'Qhp�
ORW: yes/e) PNA: yes/qo
Type of Project/ Activity
She a Le h zfl'
r n i {h.a
(Scale: NZ5 )
re ne ngt
Access Length
�...�
Pier (dock) length _...
....
_ /`�: _
Fined Platform(s)
Floating Platform(s)
Finger p(er(s)
�Y
(`
., ,. •
� _..
i i..
Total Platform area
Groin length/#
-41
Oas.l"
Bulkhead/RiPrap length
.,.
Avg distance offshore;
'
)_
Breakwater/Sill� "^+
•
_
Max distance/length •-, -
,...
.: _ :__.,
...
Basin. channel
Cubic yards
Boat ramp '_.
...
Boathouse/BoadiR
Beach Bulldozing r-
' - I' -e,,, '" """
ti
Other T
T'
- .`r..'.^�rr•„r„""a
t.R. „r
`, t lwr Tni c
[to
Y
SAV observed- yes
Moratorium:
5r 6'
ryas yes no
Site Photos: 5
no
Riparian Waiver Attached: yes
A building permit/tuning permit may be required by:
9�6—wgY
`-CSIwW�
Age orrAypglJiyant, PRINTED Name
5lgnazore "'please read campllance statement on back of permlPv
�s�tm. °a 3a3gbz
Application Fee(s) Check #/Money Order
TAR/PAI VNEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
See additional notes/conditions on back
(Please Initial) &" w
Permit
�!i 'Z// / ZS
issuing Date Expiration Date

JIB`°""' [XCAMA ❑ DREDGE & FILL
141 GENERAL PERMIT
N9 87156
Previous permit
Date previous permit issued
Q) B C D
[K New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
I SA NCAC 7M, 1 (,(00 ❑ Rules attached. © General Permit Rules available at the following link: www.deq.nc Gov/CAMArules
Project Location (County):
Street Address/State Road/
Email h ROI Cq f.^ W Cif-tCA C X CSYY% Subdivision
City &44AAZY, zip 2-79 39,
Affected ❑CW ❑EW ®PTA ❑ES ®PTS Adj. Wtr. Body P6L(�o^^C1c' S",ckpptsp (a�rnan/unk)
AEC(s): ❑OEA ❑IHA ❑UW ❑SPIMA ❑PWS Closest Maj. Wtr. Body L.G1if fl.'Rl r, Fi0i
ORW: yes/ ( PNA: yes/r®
A
Type of Project/ Activity _I h
c4 i rrec &,,:f l 6
Shoreline Length CIO r
Access Length
Pier (dock) length
Fixed Platform(s)
Floating Platform(s)
Finger pier(s)
Total Platform area
_
Groin length/q
Bulkhead/ Riprap length
^
Avg distance offshore
Breakwater/Sill
Max distance/length
^
Basin, channel
Cubic yards
Boat ramp
Boathouse/ Boatlift
^
Beach Bulldozing
Other ' rge,
re
ITSO r 6V i 7fn
b
SAV observed: '��
yesroi
Moratorium: nla'
yes no
Site Photos:
<D no
Riparian Waiver Attached:
yes IQ
A building permit/zoning permit may be required by: L%Ytor-tXiY� �CY:wN�.t
Permit Conditions
Agent or Applicant PRINTED Name
(Scale: PITS )
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
(Please Initial)
e Ir1a�
PRINTED Name
A -
Signature **Please read compliance statement on back of permit**
'$ Ca 3038"
Application Feels) Check tt/Money Order
�Yf /zy �-11/1'tr
Issuing Date Expiration Date

&2te"'° OCAMA ❑ DREDGE & FILL NU 87156 A; B c D
GENERALPERMIT Previous permit ffs Date previous permit issued
❑X New ❑ Modification ❑ Complete Reissue ❑ Partial Reissue
As authorized by the State of North Carolina, Department of Environmental Quality and the Coastal Resources Commission in an area of environmental concern pursuant to:
15A NCAC ❑ Rules attached. ❑ General Permit Rules available at the following link: www.dea.nc goy/CAMArules
Applicant Name
Authorized Agent
Address
Project Location (County):
City
State
ZIP - Street Address/State Road/Lot#(s)
Phone # ( )
Email
Subdivision
City ZIP
Affected ❑ CW
❑ EW ❑ PTA
❑ ES ❑i PTS Adj. Wtr. Body (nat/man/unk)
AEC(s): ❑ C EA
❑ IHA ❑ UW
❑ SPIMA ❑ PWS Closest Maj. Wtc Body
ORW: yes/no
PNA: yes/no
Type of Project/ Activity
(Scale: i i "-I )
Shoreline Length
Access LengthN■
Pier (dock) length
■W
■�■
■
'■
,
ON
N
■:
Finger pler(s)..
►►:::
;.;;.;
;;
Total Platform area
Groin length/#�iiw
■
:■■■■■■i■■■
-mini■■■A
\.
■
■;N■■■
�D/■�■
NE
:..■■■.■.■..9■
■
.
H■
rM
SAV observed: yes lntc�� i
Moratorium: n/a�5 yes no
Site Photos: yes no
Riparian Waiver Attached: yes no
0
MOM
n
■
.
■
■■■
••
■■
A building permit/zoning permit may be required by: _ .t.�.i-c.n.... n i ..
Permit Conditions
❑ TAR/PAM/NEUSE/BUFFER (circle one)
❑ See note on back regarding River Basin rules
❑ See additional notes/conditions on back
I AM AWARE OF STATUTES, CRC RULES AND CONDITIONS THAT APPLY TO THIS PROJECT AND REVIEWED COMPLIANCE STATEMENT. (Please Initial)
Agent or Applicant PRINTED Name
Signature **Please read compliance statement on back of permit"
Permit Officer's PRINTED Name
Signature
Application Feels)
Check #/Money Order
Issuing Date
Expiration Date

AGENT AUTHORIZATION FOR CAMA PERMIT APPLICATION RECEIVED
Atlantic Telephone Membership CorporatiorDEC 18 2023
Name of Property Owner Requesting Permit: dba FOCUS Broadband
Mailing Address: PO Box3198 DCM-EC
Shallotte NC 28459
Phone Number: 910-754-4311
Email Address: k i o 1 d ee\ o- i r) e, Cvr.
I certify that I have authorized McGill Associates PA
Agent / Contractor
to act on my behalf, for the purpose of applying for and obtaining all CAMA permits
necessary for the following proposed development: Installation of telecommunications
(fiber optic) conduit to extend telecommunications services to underserved areas
at my property located at multiple locations
in Chowan
County.
1 furthermore certify that I am authorized to grant, and do in fact grant permission to
Division of Coastal Management staff, the Local Permit Officer and their agents to enter
on the aforementioned lands in connection with evaluating information related to this
permit application.
Property Owner Information:
���ure Signat
Ke.kk HoUell
Print or Type Name ry�
C� o l G(nQra) / �wna➢eJ
Title
o f 2- Z j
Date
This certification is valid through

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
NC 'Lap+ oFTcans ion
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P.al65h NC a�c�aq _ 15`fta
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D. Is daily
If YES,
DEC 18 2023
❑ Agent
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❑ Signature Confirmation
2. Article Number (Transfer from service label)
❑ collect on Delivery Restricted De"
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71121 2720 0001 1127
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8834 el Restriced Delvery
$
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, July 2020 PSN 7530-02-000-9053
■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the malipiece,
or on the front if space permits.
Article Addressed to:
F,3'i4h `Ixircem.5rya►1
01v5 Vii IV;fa. Rd
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9590 9402 6511 0346 5363 49
7021 2720 0001 1127
PS Form 3811, July 2020 PSN 7530-02-000-9053
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DEC 18 20i"
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CERTIFIED MAIL@ RECEIPT
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Adult Signature ❑ R( W
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■ Attach this card to the back of the mailplece,
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DEC 1 8 2023
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